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Yıl:2015; Cilt: 16; Sayı: 4>> Özet
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Anadolu Psikiyatri Dergisi; 2015;16(4):247-254
Bipolar bozuklukta B kümesi kişilik bozukluğu eş tanısı varlığının başa çıkma tutumları üzerine etkisi
H Usta, H Güleç, AG Hariri, M Güleç
İstanbul Erenköy Ruh ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul
Amaç: Bipolar bozukluğun gidişinde eş tanı olarak sık görülen B kümesi kişilik bozukluğu varlığının başa çıkma tutumları üzerine olan etkisinin araştırılarak, farklı bir profil gösterip göstermediğinin belirlenmesi amaçlandı. Yöntem: Çalışmaya remisyonda bipolar bozukluğu olan B kümesi kişilik bozukluğu eş tanısı olan 50 erkek ve 50 kadın, B kümesi kişilik bozukluğu olmayan 50 erkek ve 50 kadın alınmıştır. Katılımcılara, DSM-IV’e göre yapılandırılmış klinik görüşme formu (SCID-I) ve DSM-III-R’ye göre yapılandırılmış klinik görüşme formu (SCID-II) uygulandı. Hastaların başa çıkma tutumlarını değerlendirmek amacı ile de COPE (Başa Çıkma Tutumları Ölçeği) verildi. Bulgular: Bipolar bozuklukta B kümesi kişilik bozukluğu eş tanısı olan ve olmayan hastalar arasında başa çıkma tutumları karşılaştırıldığında, B kümesi kişilik bozukluğu eş tanısı olanların işlevsel olmayan başa çıkma tutumu puanlarının daha yüksek olduğu, sorun odaklı başa çıkma ve duygusal odaklı başa çıkma tutumları puanları arasında anlamlı bir fark olmadığı bulundu. Alt ölçekler değerlendirildiğinde duygulara odaklanma ve duyguları açığa vurma, yadsıma, geri durma ve madde kullanımı puanlarının B kümesi kişilik bozukluğu eş tanısı olanlarda daha yüksek olduğu görüldü. Sonuç: Bipolar bozukluğu olup B kümesi kişilik bozukluğu eş tanısı olup olmamasına göre ayrılan grupların klinik değişkenlerinden olan başa çıkma tutumları karşılaştırıldığında, B kümesi kişilik bozukluğu eş tanısı olanların daha fazla işlevsel olmayan başa çıkma tutumları kullandığı görüldü. Bu, bipolar bozukluk hastalarına yaklaşımda, psikososyal girişimler açısından tedavi ekibi için önemli olabilir. Bulgularımızın daha geniş ve farklı eş tanılı hastalarla yinelenmesi gerekmektedir
The effect of cluster B personality disorder comorbidity on the coping styles in patient with bipolar disorder
Objective: The effect of the presence of cluster B personality disorders which are frequent comorbidities with bipolar I disorder on the coping strategies was investigated and also it was studied whether there was a different profile. Methods: The patients who were in remission period and had bipolar disorder were included in the study. All things considered, we included 50 male and 50 female patients who had bipolar I disorder in remission period with cluster B personality disorder, and 50 male and 50 female patients without cluster B personality disorder. SCID-I and SCID-II were used respectively. The COPE scale was also given to determine patients’ coping styles. Results: In terms of coping styles, the patients with cluster B personality disorder had higher dysfunctional coping styles scores. There were no significant differences for problem-focused coping scores, and emotion-focused coping scores among those patients. When the subscales were examined, the scores of focusing on emotions and expressing emotions, denial, retraining, and substance use subscales were higher among the patients with cluster B personality disorder. Conclusion: When the coping styles of bipolar patient groups those were divided according to having cluster B personality disorder or not were compared, it was seen that the group with cluster B personality disorder were using more dysfunctional coping styles. These findings can be important with regards to psycho-social interventions. Our findings must be replicated with larger and different comorbidity groups.

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